People are not just weary of Labour (although they are weary
of Labour), they are weary of politics and politicians. The 2010 general
election saw the first hung Parliament in the UK since 1974, but with a couple
of crucial differences. In 1974 there was a turnout of almost 80%, by 2010 this
had fallen to just over 65%. Additionally, there has been the stampede for the
right among the main stream parties which seen them gradually merge in ideological
terms. The most likely reasons for this can be found in the privatisation
programmes of the 1980’s which let those who would place profit above all else break
free of their leash. These companies are natural benefactors to the
conservative party, donating money in the hope for further favourable reform
and to prevent the other parties taking away all that they had already won. Political
parties need funding to get elected, and the best prospect of increasing
funding is through donations. Indeed, it has been estimated that the
Conservative party is able to raise ten times as much as its nearest competitor.
Labour in particular have had to look for other sources of revenue to compete,
and not too many rich individuals or corporations want to donate to you if it
states in your party rules that you are going to increase their income tax or nationalise
their business at the first opportunity.
Regardless of the stance of the incumbent government, in
past decades the effective privatisation of the NHS - the crown jewel of the
world’s most progressive welfare state - would have been unthinkable. Why? Because
fresh in people’s minds was the exploitation that occurred the last time
political and economic power was concentrated in the hands of the wealthy. Times
change and memories fade, eventually it becomes politically tenable to suggest
that greed is good once more. Enough years have passed in the UK for society to
forget the squalor and misery that the greed of a few had caused during the 19th
and early 20th century. Already, we debate the costs of vaccines and
medicines without giving thought to the fact that a lack of these once meant
that 140 babies per 1000 born used to die at birth, the NHS era has helped this
figure to fall to just 5.8 per 1000 babies born. We now overlook the fact that the NHS era has
seen life expectancy for both men and women increase by 75%. Your mind will no
doubt be leaping to Andy Burnham’s recent speech by now and clinging to his
promise to repeal the changes that the government have made. Sorry, that is not
what he said. He actually said that he will repeal as many of the changes as he
can without having to go through another costly reorganisation of the NHS. Subtly
different perhaps, but politicians do subtle very well. Do you remember Cameron’s
promise of no more top down reorganisation of the NHS? Or his pledge to cut the
deficit not the NHS? (OK, actually that second one just looks like a lie).What Andy
Burnham said is Political short hand for “Actually I’m glad the Tories and the
Lib Dems are going to take the fall on this one, for my part I shall do my best
to look heroic without ever promising to do anything different”. And nothing
different he will do, since by the time of the next election the Labour party
will be trying to cultivate the donations of the new breed of firms growing
quickly in the health sector.
The Health and Social Care Bill is a document the size of a
telephone directory and consequently it is difficult to predict the exact shape
of what is to come now that the Bill is to become law. The model the government
will probably use is to provide some sort of poor patient premium to make sure
patients in disadvantaged areas get the same level of care as their more
affluent counter-parts. This will mean that the very well paid will have access
to excellent healthcare (since they pay their own premium), and the very poor
will have access to healthcare (since the taxpayer will pay their premium) but
the larger number in the middle will have to make do with the second rate
services that are left (since they will be no-ones priority) or scrape together
the money to go private? Over time the number of people eligible for assistance
will fall (just like legal aid did), as will the number of services available
to people free of charge (just like the post offices and the trains). At every stage
health companies will scream for greater subsidies since they cannot afford to
keep providing treatments for free with the rising costs of drugs and medical
procedures. As a result taxes will have to increase as someone has to pay for
all of this, and the only real differences from how the system works now will
be the lower standards of care available to the vast majority, and the huge
sums of money leaving in profits.
Still, if you didn’t see this coming, don’t
worry. Don’t lambast yourself if you voted Liberal Democrat or even
conservative, it wasn’t your fault. Labour would have done the same as the
coalition has in almost every area (compare their manifestoes if you have any
doubts) and so had they retained their mandate Labour voters would be feeling
just as bad right now. Just look at Labour’s proposed amendments to the ‘Workfair’
scheme: “guaranteed job, but no benefits if you don’t take it” just how is this
materially different to what their rivals proposed? This then is why we shouldn’t
mourn the NHS. Undoubtedly the changes will lead to the rich getting richer and
everyone else getting less. Undoubtedly they will lead to many instances of
poorer care, of death or incapacity. But the simple fact is that the changes to
the NHS have only been possible because there is no credible practical alternative
in our political system. In short, these changes have only been possible
because democracy itself has already been privatised!
